A life-extending medication for patients with HER2-low metastatic breast cancer has become accessible through England’s National Health Service, marking a reversal of a previous decision that deemed the treatment unaffordable. The drug, Enhertu, can extend survival by approximately seven months on average, with some patients living significantly longer. Women in Scotland have had NHS access since 2023, and the medication is available across 26 European nations.
The availability shift comes after sustained advocacy from patient groups and charities beginning in 2024, when the National Institute for Health and Care Excellence initially rejected Enhertu as not representing adequate value for money. The decision affects approximately 1,000 women annually with the specific cancer variant. Wales is expected to follow shortly, while doctors in Northern Ireland can already prescribe it pending formal approval completion.
Health Secretary Yvette Cooper acknowledged the role of campaigners in securing the reversal. However, Breast Cancer Now noted that thousands have been unable to access the medication during the intervening period, with some patients dying while waiting. The charity emphasized both relief and the cost of the delay in its response.
Analysts attribute the reversal primarily to a trade arrangement with the United States that increased NHS medicine spending allowances. The threshold for cost-effectiveness per quality-adjusted life year rose from £30,000 to £35,000. Additionally, NICE introduced refined methodology for assessing patient quality of life in late August. Drug manufacturers Daiichi Sankyo and AstraZeneca have not materially reduced prices since the initial rejection. AstraZeneca called for enhanced collaboration to expedite future patient access, while NICE leadership acknowledged the decision arrives too late for numerous families.
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